Urethroplasty in radiation-induced strictures

Abstract

In patients presenting with urethral stricture disease, the mainstay of definitive treatment is urethroplasty. Until recently, it was unclear if urethroplasty was a feasible option in patients with urethral stricture secondary to pelvic radiation exposure. We review the feasibility and outcomes for urethroplasty in patients with radiation-induced urethral stricture. Urethroplasty in patients exposed to radiation can be technically challenging secondary to stricture location and tissue damage; however, it still has an acceptable success rate with durable outcomes. Most radiation-induced strictures are limited in length, located in the bulbomembranous region, and are amenable to excision and primary anastomosis. There are higher rates of postoperative urinary incontinence in this cohort when compared with outcomes for urethroplasty without radiation exposure; however, erectile function appears to be preserved. Recent studies highlight that urethroplasty has acceptable success rates in men with radiation-induced urethral stricture. Patients in this cohort need to be counseled on the potential for urinary incontinence following urethroplasty.